Chronic Pain Relief Through Cooled Radiofrequency Therapy

August 2018

As a person ages, increasing joint pain in the knees and hips is not uncommon, and for many, relief can be found through joint replacement surgery. But there are those who either face health concerns that prohibit surgery altogether or who have found their surgery did not eliminate their pain.

The specially trained nursing and support staff work alongside Washington University pain management specialists and board-certified anesthesiologists, including Bakul R. Dave, MD and Anthony H. Guarino, MD, director of the Pain Management Center. Drs. Dave and Guarino have been providing this cutting-edge procedure to patients and are seeing positive results.

“We now have an option to treat intractable pain in the knees and hips that was not available five years ago,” Dr. Guarino says. “There is no rehab required for most patients. If they take it easy the next day, they can usually get on with their lives.”

Cooled radiofrequency therapy is a nerve-burning procedure that alters the nerve signals coming from painful joints, Dr. Guarino says. It gives about six months of pain relief and can be repeated.

The procedure is similar to radiofrequency ablation, often used in the treatment of back pain, says Alex Fridman, RN, assistant nurse manager of the Pain Management Center. “Compared to radiofrequency, cooled radiofrequency allows for higher power delivery and treats a larger volume of treated tissue,” he says.

The outpatient procedure typically takes a little more than two hours because patients may receive minor sedation to help with the pain associated with the procedure.

“The risk for complications is very low,” Dr. Guarino says. “Every procedure has some discomfort, but we try to minimize it. Usually within four to six weeks, I follow up with patients and we can determine if the procedure has been successful.”

Finding relief from pain amid health concerns

Viola Phillips, 76, found success almost immediately after undergoing cooled radiofrequency therapy at the Pain Management Center for both of her hips.

Phillips has been battling a series of health concerns over the years, including cancer, diabetes, and heart and kidney problems. In addition, she’s had severe back pain that contributed to her hip problems.

When a family member recommended she see his physician, Dr. Guarino at the Pain Management Center, for her back problems, she took him up on the offer, and the two traveled from Perryville, Mo., to Barnes-Jewish West County Hospital in Creve Coeur. While undergoing treatment for her back pain, Dr. Guarino told Phillips about a new procedure he was going to do that might help her hips.

“My hips are bone on bone, and I need total replacements, but due to my health problems, I’ve been told it’s totally impossible,” she says. “I was Dr. Guarino’s first patient, and the results were miraculous. I had tremendous relief almost immediately.”

Dr. Guarino says for patients like Phillips, joint replacements are out of the question because they put too much stress on an already stressed body.

“I wish I had done this procedure sooner. It didn’t take long at all and has really made a difference in my life,” Phillips says. “I can’t praise Dr. Guarino enough and everyone in his office. His whole staff is so kind, caring and helpful. They are 100 percent top-notch.”

Thanks to her nephew, whom she calls “one in a million” and his recommendation of Dr. Guarino, she feels like she has a new lease on life. “I live a pretty fulfilling life, and I want to keep doing that as long as I can,” she says. “This has helped me stay active and independent.”

And that’s all Dr. Guarino can ask for. “We want our elderly population to be active. Joint pain can affect your overall health and be a detriment to your quality of life,” he says. “I’m excited we can offer this procedure to patients and help them have fuller lives.”